Shooting From The Hip

(Published September 9, 2010)

“Doctor Pete” was fifty-one when I started my residency in Family Medicine. “Family Practice” we called it then, and I think I liked that name of our specialty better. It implies continued learning and brings to my mind visions of practicing a down-to-earth craft.

I had interviewed with his predecessor the summer before and was really impressed with him and the program. I ranked it as my first choice in the match. Fortunately, they ranked me number one or two, so I was accepted, even though I may have seemed like a wild card as their first foreign-trained physician.

In the spring, a few months before I was due to move from Sweden to the United States, I got a letter in the mail with the news that the residency director was moving on after getting the program off the ground. “Doctor Pete”, his Associate Director, would be taking over. He assured me that things would continue the way they were and hoped to get to know me soon.

“Doctor Pete” was a congenial, relaxed yet energetic man with strong, hairy arms, weather-beaten cheeks and a Midwestern accent. He exuded confidence and common sense. He was one of the first Board Certified Family Practitioners in our state, and he had been chief of Family Practice, Obstetrics and Coronary Care at a small hospital a hundred miles away before joining the residency program three years before my arrival.

He spoke from experience. If he hadn’t seen it, he had at least seen something pretty close, and he always knew what to do. He was always ready to help you out, not by taking over, but by nudging you in the right direction. His pride when you mastered a difficult new situation was like a father’s pride. He had raised five adopted children, and you were just one more – that’s how it felt.

I remember a session when we had to give feedback to the faculty of our residency program. I told “Doctor Pete” that even though I really admired his experience and clinical skills, I sometimes wished he would back up his answers to some of my questions with more scientific literature. I thought he had a tendency to make things seem a little too simple sometimes. With his slight drawl, I thought of him as slightly cowboy-ish, and I remember describing his style as sometimes “shooting from the hip”.

I don’t remember his response, but I remember my critique seemed to roll off him. We continued to enjoy the most powerful mentoring relationship I ever had in my training.

I am now older than “Doctor Pete” was the day he grabbed and shook my hand at our graduation ceremony. I remember he slapped my back and made some wisecrack in his raspy voice as if trying not to get too sentimental.

I find myself quoting more scientific articles when I talk with patients or younger colleagues than “Doctor Pete” used to, but not always. When the chips are down and something needs to be done fast and without dilly-dallying or when I feel a little stuck and the details of a case don’t fit together quite the way they ought to, I have this tendency to just follow my instinct. Don’t ask me how I get to my decision in those situations. I could justify things afterwards, but I have to admit it: There are times when I seem to hit the bull’s-eye just shooting from the hip.

Just like you, “Doctor Pete”!

(In Memoriam WRP, MD, 1930-2008)